MONITORING DAN EVALUASI
PELAKSANAAN PEMBANGUNAN INSFRASTRUKTUR DESA
TAHUN ANGGARAN 20.....
Bahwa pada hari ini,
Hari : ........................................... Pukul : ...........................................
Tanggal : ........................................... Tempat : ...........................................
telah diadakan acara Monitoring dan Evaluasi Pelaksanaan Pembangunan Infrastruktur Desa di Desa .................... pada tahun anggaran 20....
oleh Tim Monev Kecamatan. Adapun kegiatan tersebut meliputi hal sebagaimana berikut:
I. KEGIATAN
Volume* Pemanfaat Waktu Pelaksanaan Sumb
Papan Prasasti
No Kegiatan Lokasi RAB Anggran Realisasi er %
P L T U Proyek Kegiatan L P Mulai Selesai Dana
1 Pemb. Darinase RT.02/04 100 2 0.75 1 √ √ √ 100 50 5/7/20.. 15/9/20.. 50.000.000 50.000.000 DD 100
2 Pemb. Jalan Aspal RT.09/01 2000 3 - 1 √ √ √ 500 675 5/7/20.. 15/9/20.. 153.389.000 153.389.000 DD 100
*) P: panjang, L: lebar, T: tinggi, U: unit
II. CATATAN MONITORING DAN EVALUASI
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III. REKOMENDASI
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Dengan monitoring dan evaluasi tersebut, maka kegiatan telah dilaksanakan sebesar ........... persen, dan memberikan pernyataan akan
menyelesaikan pada hari .................... tanggal .................................... Demikian Monitoring dan Evaluasi Pelaksanaan Pembangunan Infrastruktur
Desa di Desa.
...nama kecamatan...,............................20...
TIM MONEV KECAMATAN PEMERINTAH DESA
No Nama Jabatan Ttd No Nama Jabatan Ttd
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